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1.
Lijec Vjesn ; 137(3-4): 91-5, 2015.
Artigo em Servo-Croata (Latino) | MEDLINE | ID: mdl-26065286

RESUMO

Calcific uremic arteriolopathy or alciphylaxis is a malignant form of calcification of small arteries and arterioles, usually present in patients with chronic kidney disease and dialysis therapy. It causes high mortality. Histological distinctive feature are calcium deposits lining vascular intima. Calcification of medial muscle layer, inflammation and necrosis of subcutaneous adipose tissue are frequent. The disease begins with painful violaceous mottling, resembling livedo reticularis. Ths skin lesion progresses to ulcers and eschars, sometimes it becomes very vulnerable to secondary infection which can often develop into fatal sepsis. Our first patient with proximal form of calciphylaxis dies in repeated sepsis. The second patient with the distal form of calciphylaxis was treated successfully. The decisive moment was the use of calcimimetic. A multiinterventional strategy is likely to be more effective than any single therapy. It is necessary to regulate metabolism of calcium phosphate and secondary hyperparathyroidism. Effectiveness has been demonstrated using calcimimetics, sodium thiosulfate, oxygen therapy, careful application of biphosphonates and surgical procedures. Warfarin withdrawal is urgently recommended and subsequent vitamin K supplementation is appropriate. The control of infection is critically important and the use of carbonylated hemoglobin in the stage without infections could accelerate the wound healing.


Assuntos
Arteríolas/patologia , Calciofilaxia/terapia , Calcificação Vascular/terapia , Calciofilaxia/complicações , Calciofilaxia/patologia , Terapia Combinada , Difosfonatos/uso terapêutico , Feminino , Humanos , Oxigenoterapia , Sepse/complicações , Tiossulfatos/uso terapêutico , Calcificação Vascular/complicações , Calcificação Vascular/patologia , Vitamina K/uso terapêutico
2.
Lijec Vjesn ; 129(12): 396-400, 2007 Dec.
Artigo em Servo-Croata (Latino) | MEDLINE | ID: mdl-18383742

RESUMO

A patient with classical type of Fabry disease is described. The appearance and character of neuropathic pain during hemodyalisis is described. Characteristic changes in head shape and changes of hands and fingers are the additional phenotypic characteristics of Fabry disease. Enzyme replacement therapy administered in the early phase of the disease could prevent disease complications and early patient's death.


Assuntos
Doença de Fabry/diagnóstico , Adulto , Angioceratoma/complicações , Doença de Fabry/complicações , Humanos , Masculino , Neoplasias Cutâneas/complicações
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